A diagnosis that is usually made late, symptoms that are confused with everyday complaints and an origin that science is only just beginning to decipher: This is how it comes about Ovarian cancer. It is the eighth most common tumor in women responsible for this 3.7% of cases cancer in women worldwide National Cancer Institute.
Asia concentrates the 54.9% the diagnoses and Europe He 21.4%. The annual death rate is expected to increase by almost 10% 70% by 2050 due to population aging. The overall five-year survival rate is approx 51.6%.
In this scenario, an important finding redefines the way this pathology is understood: the fallopian tube is the most common starting point for this type of tumor, according to new research.
In an interview with Health MattersThe Dr. Marion CurtisResearcher from Mayo Clinic in Phoenix, Arizona, provided details on non-specific symptoms, genetic risks and new treatment strategies for a disease difficult to detect in the early stages.
Although it occurs less frequently than other gynecological tumors, ovarian cancer is characterized by its complexity and high mortality due to late diagnosis, according to the American clinic.
Dr. Curtis explained that, in about 70% of casesOvarian cancer with high malignant potential does not arise in the ovary, but in the fallopian tube. “We think it spreads early to the ovary, where it finds growth factors necessary for development in the abdominal cavity,” he said. Furthermore, he specified that the abdominal cavity It is the abdominal area where most of the digestive organs are located.
The specialist clarified that this is the case with tumors in the fallopian tubes, although there may be confusion in the terminology specific diagnosis. However, neoplasms of the fallopian tube, ovary, and abdominal cavity are often grouped together because they divide clinical features and treatment.
Curtis claimed that the origin is likely to be a stem cell from the endometrium that travels and implants in the fallopian tubes, ovary or peritoneum, but acknowledged that this process is not yet fully understood.
As Curtis explained, the symptoms of ovarian cancer are usually non-specific: they can manifest as swelling, Pain in the pelvis or the abdomen, Changes in appetite, Urinary tract diseases either Back pain. The specialist emphasized that due to the variety and ambiguity of these signs, the diagnosis in most patients is made only at an advanced stage. “We usually attribute these complaints to everyday causes,” he admitted.
Regarding the risk factors, Dr. Curtis this Age is the most important: Most patients are diagnosed after menopause. He also emphasized the importance of mutations in genes BRCA-1 And BRCA-2which increase the risk of breast and ovarian cancer.
Although menopause is usually associated as a trigger, Curtis explained that the accumulation of cellular defects throughout life promotes the occurrence of epithelial cancers such as ovarian cancer in later life.
People who carry BRCA mutations usually develop cancer before menopause. For this reason, the specialist recommended thinking about it Genetic testing in families with a history of these tumors in order to better assess the individual risk.
Curtis made it clear that there are currently none effective screening method and widely used in ovarian cancer. He explained that although there are tests such as the determination of the CA125 protein, their sensitivity is not sufficient for early detection.
According to the researcher, studies are being conducted at the Mayo Clinic to detect cancer cells in menstrual tampons, which would allow them to be transported to the clinic non-invasively. Although he found this research promising, he cautioned that it still needs further development before it can be used on a large scale.
Difficulty accessing the initial lesions, which usually form deep in the abdomen, and the lack of a reliable blood marker make it difficult to perform screening tests similar to those for other cancers. “He Ultrasonic has been considered but has problems with both sensitivity and specificity. Proof of a mass is not enough: an invasive biopsy would be required to confirm the diagnosis, making its practical application difficult increases costs“, he explained.
Ovarian cancer prevention remains a challenge. According to Dr. Curtis, unlike other gynecological tumors, there is no clear evidence that environmental or lifestyle factors such as obesity or diet are associated with the risk of developing the disease.
However, Using oral contraceptives, having children and taking metformin – a drug for type 2 diabetes – are associated with a lower incidence. Reducing the number of menstrual cycles appears to reduce the risk, as repeated ovulation favors the appearance of cellular defects.
The specialist pointed out that the Hormone therapy After menopause, the risk may increase, while oral contraceptives have a protective effect. In people with BRCA mutations, removal of the fallopian tubes drastically reduces the risk of cancerand it is increasingly a sought-after option when performing other pelvic surgeries.
Diagnosis usually occurs in advanced stages with metastases in the abdomen or peritoneum, which limits the healing options. In the early stages, a cure is possible, although rare. The five-year forecast is around 30% in the advanced stages.
The standard treatment remains the combination of surgery and chemotherapy, although “remissions are rarely long-lasting,” Curtis warned. The CA125 marker is used to monitor recurrences.
Among recent advances, Dr. Curtis highlighted the Mayo Clinic’s experiments with immunotherapy T cells of the patient to create a “memory” that can counteract future relapses. This method targets a protein found in multiple tumors, which could expand its application to other oncological diseases.
Additionally, the identification of a unique tumor antigen in ovarian cancer opens the door for future vaccines to prevent recurrence.
The specialist expressed optimism about the future of immunotherapy, believing that strengthening the immune system is a promising way to improve the chances of survival and offer new perspectives to those facing this cancer.
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